Adjustment of hemodialysis dose for residual renal urea clearance: a two year study of impact on dialysis time
| Autor: | Jose E Lozano, Melissa J Ishler, Afzal ur Rehman, Allan H. Sklar, A. Serdar Atav, Mahmud S Khan |
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| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Time Factors Metabolic Clearance Rate medicine.medical_treatment Biomedical Engineering Biophysics Urology Bioengineering Kidney Biomaterials chemistry.chemical_compound Renal Dialysis medicine Humans Urea Prospective cohort study Dialysis Urea clearance business.industry Kidney metabolism General Medicine Maintenance hemodialysis Surgery chemistry Dose reduction Hemodialysis business |
| Zdroj: | ASAIO journal (American Society for Artificial Internal Organs : 1992). 48(4) |
| ISSN: | 1058-2916 |
| Popis: | Urea kinetic modeling suggests that significant time reductions may be realized in hemodialysis patients with residual renal urea clearance (K(r)t/V urea). However, the actual impact of a strategy that integrates such function into the dialysis prescription is not clear, because of both uncertainty regarding the rate of decay of K(r)t/V urea, as well as potential clinical constraints upon dose reduction. To examine this issue, we retrospectively reviewed data from 51 patients with K(r)t/N urea after initiation of maintenance hemodialysis. In 31 cases, there were no clinical barriers to adjustment of the dialysis prescriptions. Regression analysis revealed that each 0.10 increment in K(r)t/V urea yielded an actual dialysis time reduction of 12 minutes per week with average cumulative reduction of 80 minutes per week per patient. At approximately 1 year after initiation of dialysis, there were still 10 patients whose dialysis prescriptions were being adjusted on the basis of K(r)t/V urea. In conclusion, our results suggest that the incorporation of K(r)t/V urea in the hemodialysis prescription allows for substantial and enduring reductions in dialysis time in a significant minority of patients. Larger prospective studies are needed to evaluate the long-term safety of this strategy in modifying the dose of hemodialysis. |
| Databáze: | OpenAIRE |
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